As
I have stated, there is no solid evidence of patient benefit from use of an
EMR. Security and privacy issues are worrisome. The EMR destroys the patient
narrative and disrupts the physician-patient relationship. Humans do not speak “template”.
As psychiatrist Dr. Scott Monteith has stated, “it really affects how we think”.

9 comments:

I agree that the Meaningless Use program should end. However, I disagree that the EMR is to blame for poor physician-patient communication. Each physician has to decide if and why an EMR will work for him/her.

Thanks for your comment Arvind. I do think that the EMR does not enhance and does detract from meaninful sensitive caring communication. It is also a drain on physician time, reduces productivity, costs physician and taxpayer money and has not been shown to improve care and may very well lead to worse outcomes! We must admit that there are no well controlled studies showing benefit.

EMR user since 2006. I had NUMEROUS patients transfer from my practice the minute that they saw me using a computer -- a notebook, with a pen, where I could still look at them and talk normally. I hope they are happy now in their with their new doctors as that practice goes through the hell on earth which is the start up year with the EMR. NONE none none of the programs now on the market are good enough for doctors to use. The newer ones are a little cleaner than the older ones, since they have not been added onto and remodeled like an old house. This meaningful use stuff is a joke and a half. Despite being totally dependent upon the EMR, we still had to kill ourselves to demonstrate "use." With an EMR, the doctor becomes his/her own secretary. I had a right carpal tunnel release two years ago, and now need time to schedule the left. I either spend hours writing my charts at night or pay the piper later on a "paperwork" day. Excuse me, but I could talk and talk on this subject. Not that EMR could not work, but nothing commercially available is good enough yet, and I say yet with unwarranted optimism.

DrMarie: I hear your distress. This is so sad for so many. And so burdensome. But alas, like so many, you felt or were coerced. You stated it clearly about being a secretary. Many doctors I have spoken to express the same, as if they are glorified clerk or data entry techs.No need to apologize. May the force be with you in your daily work in this still noble profession of ours.

Just spent our first two days going live with McKesson. I expect a learning curve, but I feel the pain of everybody. Love the comment that Doctors don't speak template. I am a pretty good typist and I think I will chuck the templates and just type my notes and use an abbreviated template for the physical part so I dont have to type lung, heart ENT, abd each time. I see templates good for all the normal things, but they are crap when it comes to documenting the abnormal. EMR are going to end up helping the trial lawyers and regulators more than the doctors or the patients. Most EMR notes now are crap and you have to wade through tons of worthless non-sense to see the important parts of the note.

Report problems to FDA MedWatch (https://www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm) -- see http://hcrenewal.blogspot.com/2011/01/maude-and-hit-risk-mother-mary-what-in.html to see the types of defects you will be held responsible for if they result in malpractice, not the IT seller -- and other suggestions are at the end of the post at http://hcrenewal.blogspot.com/2012/03/doctors-and-ehrs-reframing-modernists-v.html

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